Police fail to respond to psychiatric units amid rise in attacks on staff

Guardian FoI request suggests possible link with Met decision to attend calls only when there is ‘significant threat to life or limb’

The Met told officers in 2013 to stop responding to calls from mental health units and emergency departments for help unless there was a ‘significant threat to life or limb’.
Photograph: Christopher Thomond for the Guardian

Monday 7 March 2016 05.36 EST
First published on Monday 7 March 2016 01.00 EST

Police refused to respond to calls for help from staff at psychiatric units covering a large swath of east London and Essex on more than 125 occasions last year.

The figures were released in response to a Guardian freedom of information request that sheds new light on how overstretched staff in mental health units are increasingly on the receiving end of violence.

The high number of non-responses may be connected to a decision by the Metropolitan police in 2013 to stop responding to calls from mental health units and emergency departments for help to control and restrain patients unless there is a “significant threat to life or limb”, although the force denies this. The Met says it continues to attend situations that require a police presence.

One front-line mental health nurse who did not want to be named said that staff in psychiatric units can face a variety of threats from disturbed and vulnerable patients: “It might be someone with a weapon, they may be barricading themselves in a room, furniture might be sent flying, or the worst can be a hostage situation.

“I am pretty alarmed to hear they [police] are not coming out,” the nurse said, “because I think that mental health staff probably have too high a threshold for what they tolerate and manage themselves. If they have got to the stage where they call 999 then that is probably a really desperate situation.”

Most London NHS trusts are not recording the number of police refusals to respond. However, more than 125 such instances were recorded last year by the NELFT NHS Foundation Trust – which provides services across the north-east London boroughs of Barking and Dagenham, Havering, Redbridge and Waltham Forest – and in Essex.

Staff working in the trust’s psychiatric unit called for help 313 times last year, and, in a 35% increase on the previous year, were assaulted 291 times.

Another trust, the West London Mental Health NHS trust, was among those that did not record whether the police had refused to act when called staff called for assistance. However, it provided figures showing that police attended 25% of the 1,187 incidents they were notified about last year and that the attendance rate has been dropping over the past three years.

The Orchard psychiatric unit in Ealing, part of the West London Mental Health NHS Trust. Photograph: Felix Clay for the Guardian

The Metropolitan police said it continues to attend calls relating to mental illness that require a policing response and that work is ongoing through the National Police Chiefs’ Council (NPCC), College of Policing and “health partners” on policy and protocol.

It added: “It is accepted by all partners that there has been an unnecessary reliance on police to manage what is accepted as ‘foreseeable risk’ and that this should be managed without the need for policing assistance. In many circumstances, health partners have far more powers than the police do to deal with situations occurring within health premises.”

Other figures released under FoI – which cover up to November last year – reveal that staff in psychiatric units are coping with significant levels of violence that are rising dramatically in some places.

The number of assaults at the East London NHS foundation trust has risen from 11 in 2013 to 258 last year. The number of occasions in its psychiatric units where staff have called for help from police has steadily risen over recent years – up to 617 last year.

Staff working for Camden and Islington NHS foundation trust were assaulted on more than 283 occasions last year, a 74% increase on the previous year. They called for help from police on at least 32 occasions, compared to 20 in the previous year and once in 2013.

Unison’s general secretary, Dave Prentis, said the figures showed “an intolerable level of attacks on staff”.

He added: “Violent episodes involving patients can be managed where facilities have enough trained mental health staff. Relying on the police at a time when cuts mean forces around the country are finding it increasingly difficult to attend every incident is clearly not working.

“There are now too few staff in the mental health service and the police to deal with these vulnerable patients safely. It is worrying that these figures are on the rise, despite political assurances that providing the funding for mental health beds is a priority.”

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Staff in psychiatric units at the South West London and St George’s Mental Health NHS trust were assaulted 526 in the first 11 months of last year, compared with 359 and 132 in the two years previously.

At the Central and North West London NHS foundation trust, staff were assaulted on more than 449 times last year, compared with 551 and 573 respectively in the two years before.

At South London and Maudsley NHS foundation trust, staff were assaulted on more than 980 occasions in the year up to November, compared to 1,052 and 1,015 respectively in the two previous years.

Barnet, Enfield and Haringey Mental Health NHS trust said that police were called on 381 occasions in the first 11 months of last year following assaults on staff. The figure was more than 1,000 for each of the previous two years. The trust does not record whether help has been refused.